Knowledge and Perception of Radiation Risk From Computed Tomography Scans Among Patients Attending an Emergency Department.

To evaluate the level of knowledge about radiation dose and possible risks related to computed tomography (CT) scans among patients visiting emergency departments (EDs), a survey was conducted over a two-month period. A total of 357 adult patients (44% men and 56% women) presenting for diagnostic imaging in the ED answered a survey consisting of 15 questions. The survey included questions about the participants' demographics and knowledge of radiation. Most of the respondents (58.5%) reported that the physician did not explain the potential risk of radiation before the procedure. In addition, more than half of the respondents (58.1%) expressed feeling anxious about the potential risk of radiation. Most respondents (84.9%) stated that the potential radiation risk did not affect their decision to proceed with the procedure. Overall, the findings highlight a lack of information about radiation and its potential risks provided to patients prior to the diagnostic procedure. Increasing awareness and understanding of the risks associated with these imaging modalities should be considered essential in modern communities. Efforts should be made to ensure that patients undergoing diagnostic imaging are aware of the radiation risks they may encounter.

Reduced Cortical Complexity in Children with Developmental Delay in Saudi Arabia.

INTRODUCTION: Developmental delay (DD) is a neurodevelopmental disorder characterized by delays in multiple domains. The investigation of brain structure in DD has been enhanced by advanced neuroimaging techniques that can identify regional surface deformities. Neuroimaging studies have identified structural brain abnormalities in individuals with DD, but research specific to the Saudi Arabian population is limited. In this study, we examine the neuroanatomical abnormalities in the cortical and subcortical regions of Saudi Arabian children with DD. METHOD: A T1-weighted, 1-mm-thick MRI was used to acquire structural brain images of 29 children with DD and age-matched healthy controls. RESULTS: Analysis of the MRI data revealed significant differences in several cortical and subcortical structures of gray matter (GM) and white matter (WM) in several brain regions of the DD group. Specifically, significant deformities were observed in the caudate nucleus, globus pallidus, frontal gyrus, pars opercularis, pars orbitalis, cingulate gyrus, and subcallosal gyrus. These findings suggest disrupted neurodevelopment in these regions, which may contribute to the cognitive, motor, and behavioral impairments commonly observed in individuals with DD. CONCLUSIONS: The present study provides valuable insights into the neuroanatomical differences in Saudi Arabian children with DD. Our results provide evidence for cortical and subcortical abnormalities in DD. Deformities in the observed regions may contribute to cognitive impairment, emotional dysregulation, mood disorders, and language deficits commonly observed in DD. The structural analysis may enable the identification of neuroanatomical biomarkers to facilitate the early diagnosis or progression of DD. These results suggest that lower cortical complexity in DD children due to alterations in networks may play a critical role in early brain development.

Safety Survey on Lone Working Magnetic Resonance Imaging Technologists in Saudi Arabia.

PURPOSE: The American College of Radiology (ACR) requires MR personnel not to work alone due to the increased risk of safety issues such as projectiles, aggressive patients, and technologist fatigue. As a result, we intend to assess the current safety of lone-working MRI technologists in MRI departments in Saudi Arabia. MATERIALS AND METHODS: A cross-sectional study using a self-report questionnaire was conducted in 88 Saudi hospitals. RESULTS: A response rate of 64% (174/270) was obtained among the 270 MRI technologists which were identified. The study discovered that 86% of MRI technologists had prior experience working alone. In terms of MRI safety training, 63% of MRI technologists received such training. A question about lone MRI workers' awareness of the ACR's recommendations revealed that 38% were unaware of such recommendations. Furthermore, 22% were misinformed, believing that working alone in an MRI unit is optional or depends on the individual's desire to work alone. Working alone has the primary consequence of being statistically significantly associated with projectile/object-related accidents/mistakes (p = 0.03). CONCLUSION: Saudi Arabian MRI technologists have extensive experience working alone without supervision. Most MRI technologists are unaware of lone working regulations, which has raised concerns about accidents/mistakes. There is a need for MRI safety training and adequate practical experience to raise awareness of MRI safety regulations and policies related to lone working among departments and MRI workers.

Common diagnoses and factors associated with abnormal neuroimaging in headache patients in the emergency department.

OBJECTIVES: To determine causes of headaches in patients who presented to the emergency department (ED) and underwent neuroimaging, and to determine the clinical features associated with abnormal neuroimaging. METHODS: Patients were retrospectively selected from a database between June, 2015 and May, 2019. Patients were included if they had neuroimaging requested from the ED mainly for headache. Associations between clinical characteristics and abnormal neuroimaging were assessed. RESULTS: We included 329 patients (33.4% men, 66.6% women). The mean (SD) age was 39.7 (18.4) years. Neurological signs were reported in 43.8% of the patients, head-computed tomography was requested in 79.6%, magnetic resonance imaging in 77.5%, and both in 57.1%. Abnormal neuroimaging was reported in 31.9%. The most common reported diagnoses were secondary headache disorders (48.9%), followed by primary headache disorders (16.4%). The remainder were nonspecific-headaches (35%). Variables associated with abnormal neuroimaging were headache onset ≤1 month (OR 3.37, CI 1.47-7.70, p=0.004), and presence of an abnormal neurological sign (OR 3.60, CI 1.89-6.83, p<0.001). CONCLUSION: Secondary headache disorders are common in patients who undergo neuroimaging in the ED. Those who have a neurological sign and recent onset of headache are more likely to have abnormal neuroimaging.

Improving cervical spinal cord lesion detection in multiple sclerosis using filtered fused proton density-T2 weighted images.

Background: Magnetic Resonance Imaging (MRI) is considered a vital in depicting multiple sclerosis (MS) lesions. Current studies demonstrate that proton density (PD) weighted images (WI) are superior to T2 WI in detecting MS lesions (plaques) in the spinal cord. Purpose: To evaluate the diagnostic value of filtered fused PD/T2 weighted images in detecting cervical spinal cord MS lesions. Material and Methods: In this retrospective study, we selected a sample size of 50 MS patients. Using contrast limited adaptive histogram equalization (CLAHE), a digital image processing filter was used on the (PD/T2) fused images. The produced images were inspected and compared to the original PD images by two experienced neuroradiologists using interobserver and intraobserver. An ROI analysis was also performed on the processed and original PD images. Results: The repeatability measurement of the match between the two examinations was highly consistent for both neuroradiologists. The repeatability for both neuroradiologists was 96.05%, and the error measurement was 3.95%. The reproducibility measurement of the neuroradiologist's evaluation shows that the processed images could help to identify lesions better [excellent (84.87%)] than PD images [good (61.19%)]. ROIs analysis was performed on 113 MS lesions and normal areas in different images within the sample size. It revealed an enhanced ratio of 2.2 between MS lesions and normal spinal cord tissue in processed fused images compared to 1.34 in PD images. Conclusion: The processed images of the fused images (PD/T2) have superior diagnostic sensitivity for MS lesions in the cervical spine than PD images alone.

Awareness of radiation hazards in patients attending radiology departments.

Evaluating the knowledge of patients attending radiology departments regarding ionizing radiation used in medical imaging and its associated hazards can provide knowledge of the patient's awareness level of the associated risk of the radiation used in medical imaging. The aims of this study were to evaluate the awareness of patients regarding medical radiation types used in medical diagnostic imaging and its influence on their decision to proceed with that procedure. Over an 8-months period, a total of 418 patients, 48% Men and 52% Women, presenting for diagnostic imaging in the department of radiology, completed a 15-point questionnaire. The questionnaire included demographic and radiation awareness sections. Less than 32% of the participants had a potential risk of radiation explained by the doctor before the procedure. 59% of the participants expressed that the potential risk of radiation makes them anxious; less than about 25% of the participants showed that the potential risk of radiation affects their decision to have the procedure. Overall, the data collected from this survey indicate that there is a lack of information about radiation risk provided to the patients prior to the diagnostic procedure. Efforts should be made to ensure that patients receiving multiple medical imaging tests are aware of the radiation they are receiving.

Unintentional exposure and incidental findings during conventional chest radiography in the pediatric intensive care unit.

ABSTRACT: Radiation overexposure is common in chest X-ray (CXRs) of pediatric patients. However, overexposure may reveal incidental findings that can help to guide patient management or warrant quality improvement.To assess the prevalence of overexposure in CXRs in pediatric intensive care unit (PICU); and identify the incidental findings within overexposed areas, we conducted a retrospective cohort study of children who were admitted to PICU. Two independent evaluators reviewed patient's charts and digital CXRs according to the American College of Radiology standards; to evaluate overexposure of the anatomical parameters and incidental findings.A total of 400 CXRs of 85 patients were reviewed. The mean number of CXRs per patient was 4.7. Almost all (99.75%) CXRs met the criteria for overexposure, with the most common being upper abdomen (99.2%), upper limbs (97%) and neck (95.7%). In addition, 43% of these X-rays were cropped by the radiology technician to appear within the requested perimeter. There was a significant association between field cropping and overexposure (t-test: t = 9.8, P < .001). Incidental findings were seen in 41.5% of the radiographs; with the most common being gaseous abdominal distension (73.1%), low-positioned nasogastric tube (24.6%), and constipation (10.3%).Anatomical overexposure in routine CXRs remains high and raises a concern in PICU practice. Appropriate collimation of the X-ray beam, rather than electronically cropping the image, is highly recommended to minimize hiding incidental findings in the cropped-out areas. Redefining the anatomic boundaries of CXR in critically ill infants and children may need further studies and consideration. Quality improvement initiatives to minimize radiation overexposure in PICU are recommended, especially in younger children and those with more severe illness upon PICU admission.

Spatial relationship of i-gel® and Ambu® AuraOnceTM on pediatric airway: a randomized comparison based on three dimensional magnetic resonance imaging.

BACKGROUND: Gross morphological differences exist among different brands of pediatric supraglottic devices (SGDs). The aim of this study is to compare the spatial relationship of i-gel® and Ambu® AuraOnce (AO)TM on pediatric airway based on three dimensional (3-D) magnetic resonance imaging (MRI) measurements. METHODS: Sixty patients up to 12 years of age were enrolled and assigned in two groups, i-gel® or Ambu® AOTM. After confirmation of proper placement of these SGDs, 3-D MRI scans of head and neck were performed. Another native scan was also obtained after removal of the SGD for comparison. RESULTS: i-gel® produced significant degree of compression of the tongue (P<0.001) while Ambu® AOTM significantly reduced the axial diameter of glottis (P=0.033) compared to their native values. Both i-gel® and Ambu® AOTM significantly reduced the area of the glottic opening (P<0.001 for each device) and the distance between the arytenoids (P<0.001 and P=0.007 respectively); and increased the distance between the hyoid bone and cervical spine (P<0.001 and P=0.001 respectively) in comparison to their corresponding native values. Bowl of i-gel® produced greater dilation of the upper esophageal sphincter at all levels of measurement- upper (P<0.001), middle (P=0.001) and lower (P=0.015) in comparison to Ambu® AOTM. CONCLUSIONS: Based on 3-D MRI measurements done on living patients, both SGDs distorted the anatomy of pediatric airway compared to their respective native values to variable extent. The relevance of these effects needs further studies on larger patient group in order to reduce morbidity on pediatric airway.